A fourth individual has died in the multistate Salmonella Poona outbreak linked to imported cucumbers bringing the death total to four, according to the Centers for Disease Control and Prevention (CDC) Tuesday.

Sixty-one additional cases from two dozen states were reported during the past week putting the cumulative total to 732. Maryland reported their first case making them the 35th state to be affected by the outbreak.

As of October 5, 2015 the number of ill people reported from each state is as follows: Alabama (1), Alaska (14), Arizona (114), Arkansas (11), California (192), Colorado (18), Hawaii (1), Idaho (24), Illinois (9), Indiana (3), Iowa (6), Kansas (2), Kentucky (1), Louisiana (5), Maryland (1), Minnesota (37), Missouri (11), Montana (14), Nebraska (6), Nevada (14), New Mexico (31), New York (6), North Dakota (6), Ohio (2), Oklahoma (12), Oregon (20), Pennsylvania (2), South Carolina (9), South Dakota (3), Texas (34), Utah (53), Virginia (1), Washington (22), Wisconsin (40), and Wyoming (7).

150 ill people have been hospitalized, and four deaths have been reported from Arizona (1), California (1), Oklahoma (1), and Texas (1). Half the cases were in children under 18 years of age.

Cucumbers distributed by Andrew & Williamson Fresh Produce and Custom Produce Sales were recalled on Sep. 4 and 11, respectively.

The CDC says it is not unexpected to continue to see illnesses reported after the recalls, for several reasons. It can take up to a week from the time people eat food contaminated with Salmonella before they get sick. Also, cucumbers have a shelf life of up to 14 days. Some people may not have known about the recall and eaten the contaminated cucumbers after the recall.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today and the Executive Editor of The Global Dispatch

Follow @bactiman63